| ObjectiveThe purpose of this study was to explore the effect of race,marital status and age on the survival and prognosis of clear cell renal cell carcinoma.MethodDownloading data of all patients diagnosed as cc RCC from SEER database,and extracting data of 38517 patients diagnosed as cc RCC pathologically from 2010 to2014.According to the inclusion and exclusion criteria of this study,the preliminary patient data were screened,and 26690 cases that met the requirements were finally obtained.Excel software was used to sort and assign the data,chi-square test was used to analyze the classification variables,Pearson linear correlation analysis was used to verify the linear correlation.Kaplan-Meier method was used to draw survival curve,and log-rank or Breslow test was used to verify whether there was significant difference.Cox proportional regression model was used to carry out single factor and multi-factor analysis on the included variables,and Schoenfeld residual plot and cumulative risk function graphical method were used to test PH hypothesis.ResultsCox isometric regression multivariate analysis showed that apart from race,marital status and age are independent predictors of mortality in patients with clear cell renal cell carcinoma.(1)Race: From 2007 to 2016,the number of patients with clear cell renal cell carcinoma in white(r=0.987,P=0.000),yellow(r=0.972,P=0.000),black(r=0.924,P=0.000)and native North American(r=0.928,P=0.000)increased year by year.The survival curve of Kaplan-Meier method showed that there was no difference in survival prognosis among different races of cc RCC patients.(2)Marital status: The survival prognosis of married patients with clear cell renal cell carcinoma is the best,which is obviously better than that of unmarried group(HR1.256,95%CI 1.152-1.370,P<0.001)and separated,divorced and widowed group(HR 1.496,95%CI 1.393-1.606,P<0.001).(3)Age: The tumor differentiation degree of middle-aged and elderly patients with clear cell renal cell carcinoma is poor,andthe tumor diameter is often larger than that of young people when diagnosis is made,and the proportion of T3 and M1 patients is also higher in young group.Taking the young group as a reference,the mortality of cc RCC patients in the middle-aged group is 2.404 times(HR 2.404,95%CI 2.0.21-2.860,P<0.001)and the mortality of cc RCC patients in the old group is 4.913 times(HR 4.913,95%CI 4.119-5.861,P<0.001)that of the young group.Schoenfeld residual plots and cumulative risk function graphical tests show that,with the exception of race,marital status and age meet the PH assumption.Conclusion(1)The number of patients with clear cell renal cell carcinoma in white,yellow,yellow and North American indigenous populations is increasing year by year,and there is no difference in survival prognosis between patients with clear cell renal cell carcinoma of different races.(2)Married patients with clear cell renal cell carcinoma have the best survival prognosis,followed by unmarried patients with clear cell renal cell carcinoma,and patients separated,divorced and widowed have the worst survival prognosis.(3)Different ages have an impact on the survival prognosis of cc RCC patients.Young patients with cc RCC have better tumor biological characteristics at the time of diagnosis,and the survival prognosis is the best among the three groups,followed by middle-aged cc RCC patients,and the worst is elderly cc RCC patients. |
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